An Array Of Sweeteners In Senate's Fiscal Deal

New York Times :
January 1, 2013
: Updated: January 1, 2013 11:41pm

WASHINGTON — The fiscal deal approved by the Senate put off the question of broad spending cuts, but it included an array of provisions added at the behest of members of one party or the other to pick up votes or generate savings.

One such sweetener repeals a long-term-care insurance program that had been championed by Sen. Ted Kennedy.

Other provisions would help companies that produce biofuels with algae; cut Medicare payments to hospitals and radiologists; protect tax breaks for motor sports complexes and certain film and television productions; and cancel a scheduled pay raise for members of Congress.

The bill also freezes Medicare payments to doctors, which otherwise would have been cut by at least 26.5 percent in 2013.

Congress offset the cost with changes in Medicare and other federal health programs. For example, it reduced Medicare payments to hospitals by $10.5 billion over 10 years after finding many hospitals had increased their Medicare revenue by describing the severity of patients' illnesses in more detail.

“We understand the necessity for congressional action to avoid a dive off the 'fiscal cliff,'” Kahn said. “But we are disappointed that scarce hospital finances would be used to offset the Medicare physician payment fix.”

The tax and spending legislation steers clear of the most contentious proposals for Medicare savings, which would, for example, have increased the age of eligibility for the program.

The bill does squeeze savings from health care providers. It cuts Medicare payments for nonemergency ambulance transportation of kidney dialysis patients, gives the government more time to recover overpayments and trims payments to health maintenance organizations serving Medicare beneficiaries.

Under the long-term-care insurance program, workers would have paid monthly premiums during their careers and could have received cash benefits if they became disabled later in life. The program was part of President Barack Obama's health care law.

Obama administration officials suspended the program in October 2011, saying they couldn't find a way to make it financially sustainable. Many Democrats wanted to keep it on the books, in the hope it could be revived someday. But Republicans wanted to repeal it, and they got their way.